Aa
New interferon
Does anyone know when the new series of interferon drugs are coming out? Also has anyone been called for a liver transplant and the liver was bad? Also did it happen several times?
Hector, you wrote
"I have chosen NOT to accept a liver from a donor who is older (as the livers tend to fail quickly in hepatitis C transplant patients)"
When you say older do you mean older than you or some absolute age? In other words what is the definition of old in this context? And what is your source for data (or if you can, provide a bit more detail) for the statement?
regards, Dave
"I have chosen NOT to accept a liver from a donor who is older (as the livers tend to fail quickly in hepatitis C transplant patients)"
When you say older do you mean older than you or some absolute age? In other words what is the definition of old in this context? And what is your source for data (or if you can, provide a bit more detail) for the statement?
regards, Dave
"Also has anyone been called for a liver transplant and the liver was bad? Also did it happen several times?"
Are you speaking of a patient turning down a liver because of the donor's history when it was offered to them? This is quite common in patients that still have functioning livers that can afford to wait for a more ideal liver.
Or upon testing the liver they found the livers not viable for transplant. I would think that would be very indeed to have multiple donors with unhealthy livers.
Patients are given choice to choose less than "ideal livers" (sometimes called "high risk livers" so they can get a transplant sooner. Although you can choose to be open to different "non-ideal livers" you don't have to accept them. It is your choice. Patient choice of donor livers is very dependent on how ill they are. If you only have a few days to live most patients will take any liver that they can. This is especially true in transplant centers in the San Francisco, LA and New York City areas where it is not uncommon to have patients very ill and close to death before there is any liver available to them.
For example I am waiting for a transplant due to hepatitis C, cirrhosis and liver cancer. I have chosen TO ACCEPT a liver that is infected with hepatitis C (as there is no difference since I already have hepatitis C), hepatitis B (I will have to take one extra pill for the rest of my life to keep the hep B from damaging my new donor liver. I have chosen NOT to accept a liver from a donor who is older (as the livers tend to fail quickly in hepatitis C transplant patients), has a history of cancer (as I have already had 2 types of cancer).
From the UCSF Transplant Center web site....
"What's an "ideal liver"?
An "ideal liver" comes from a healthy young person who has died. Ideal livers are more likely to work well and less likely to transmit cancer or infection. In the United States, roughly a third of all liver transplants come from ideal donors. This means it's impossible for every patient to get an ideal liver.
It's important to note that it's possible to get an infection or cancer even from an ideal liver. The risk if low — probably less than one in 100 — but it's not zero. It's impossible to test donors for every type of infection or cancer, tests may not detect a problem and we may not know that the donor practiced behaviors, such as IV drug use, which would make the liver more risky. These are risks that every transplant recipient takes.
-------------------------------------------------------------------------------------------------------
What's a non-ideal liver?
Many non-ideal livers will work fine and carry only a small risk of transmitting an infection or cancer, just like an ideal liver. Other non-ideal livers carry higher risks. If your medical team believes your risk of dying while waiting for a transplant is greater than the risk from a non-ideal liver, they may offer you the non-ideal liver.
"Non-ideal" livers from the following kinds of donors carry a higher risk of transmitting infection or cancer:
A donor who was infected with hepatitis B. These livers work well but recipients need to take, for the rest of their lives, a medication that prevents them from developing hepatitis B. This medication prevents infection in more than 90 percent of cases.
A donor who was infected with hepatitis C. We don't use livers from these donors unless the recipient already has hepatitis C of a particular kind, called genotype I, and only when the liver isn't scarred from the hepatitis infection. In these cases, the results appear to be as good as if the patients had received a liver from a donor without hepatitis C.
A donor who had cancer. We sometimes use livers from donors who had a history of cancer, but only when we believe the risk of transmitting cancer is low, based on the type of cancer and the stage. When you're called for an organ offer, the surgeon will discuss the cancer risk with you.
A donor who was in prison, used IV drugs or had sex with a high-risk partner within the past year. These donors may have a higher risk of transmitting HIV, hepatitis C or hepatitis B. We test for these viruses, but if the patient has recently become infected the test may not detect them. We believe the risk of infection from these livers is quite low and for some patients, it's probably below the risk of dying while waiting for a transplant.
The following kinds of livers aren't more likely to transmit an infection or cancer, but they carry a higher risk of not working well:
A split liver or a partial liver transplant. Livers from young donors may be split into two pieces that are transplanted into two recipients. Getting a piece of a liver rather than a whole one may increase the risk of bleeding, problems with the bile duct and problems with the liver not working well.
Livers from older donors. Livers that come from donors age 55 and over appear not to work as well in patients with hepatitis C as livers from younger donors. In patients without hepatitis C, however, they appear to work just as well.
Livers donated after cardiac death. Most organ donation occurs after brain death, meaning the donor has been declared brain dead but all organs, including the heart, continue to work. When a liver's taken after the heart has stopped beating — called donation after cardiac death — there seem to be increased risks. The liver may not work as well, and the recipient may need an emergency second transplant. There also appears to be a higher rate of bile duct problems, meaning the recipient may need to have more procedures or the liver may not work well. And the risk of transplant failure appears to be 5 to 7 percent higher."
Regards,
Hector
Are you speaking of a patient turning down a liver because of the donor's history when it was offered to them? This is quite common in patients that still have functioning livers that can afford to wait for a more ideal liver.
Or upon testing the liver they found the livers not viable for transplant. I would think that would be very indeed to have multiple donors with unhealthy livers.
Patients are given choice to choose less than "ideal livers" (sometimes called "high risk livers" so they can get a transplant sooner. Although you can choose to be open to different "non-ideal livers" you don't have to accept them. It is your choice. Patient choice of donor livers is very dependent on how ill they are. If you only have a few days to live most patients will take any liver that they can. This is especially true in transplant centers in the San Francisco, LA and New York City areas where it is not uncommon to have patients very ill and close to death before there is any liver available to them.
For example I am waiting for a transplant due to hepatitis C, cirrhosis and liver cancer. I have chosen TO ACCEPT a liver that is infected with hepatitis C (as there is no difference since I already have hepatitis C), hepatitis B (I will have to take one extra pill for the rest of my life to keep the hep B from damaging my new donor liver. I have chosen NOT to accept a liver from a donor who is older (as the livers tend to fail quickly in hepatitis C transplant patients), has a history of cancer (as I have already had 2 types of cancer).
From the UCSF Transplant Center web site....
"What's an "ideal liver"?
An "ideal liver" comes from a healthy young person who has died. Ideal livers are more likely to work well and less likely to transmit cancer or infection. In the United States, roughly a third of all liver transplants come from ideal donors. This means it's impossible for every patient to get an ideal liver.
It's important to note that it's possible to get an infection or cancer even from an ideal liver. The risk if low — probably less than one in 100 — but it's not zero. It's impossible to test donors for every type of infection or cancer, tests may not detect a problem and we may not know that the donor practiced behaviors, such as IV drug use, which would make the liver more risky. These are risks that every transplant recipient takes.
-------------------------------------------------------------------------------------------------------
What's a non-ideal liver?
Many non-ideal livers will work fine and carry only a small risk of transmitting an infection or cancer, just like an ideal liver. Other non-ideal livers carry higher risks. If your medical team believes your risk of dying while waiting for a transplant is greater than the risk from a non-ideal liver, they may offer you the non-ideal liver.
"Non-ideal" livers from the following kinds of donors carry a higher risk of transmitting infection or cancer:
A donor who was infected with hepatitis B. These livers work well but recipients need to take, for the rest of their lives, a medication that prevents them from developing hepatitis B. This medication prevents infection in more than 90 percent of cases.
A donor who was infected with hepatitis C. We don't use livers from these donors unless the recipient already has hepatitis C of a particular kind, called genotype I, and only when the liver isn't scarred from the hepatitis infection. In these cases, the results appear to be as good as if the patients had received a liver from a donor without hepatitis C.
A donor who had cancer. We sometimes use livers from donors who had a history of cancer, but only when we believe the risk of transmitting cancer is low, based on the type of cancer and the stage. When you're called for an organ offer, the surgeon will discuss the cancer risk with you.
A donor who was in prison, used IV drugs or had sex with a high-risk partner within the past year. These donors may have a higher risk of transmitting HIV, hepatitis C or hepatitis B. We test for these viruses, but if the patient has recently become infected the test may not detect them. We believe the risk of infection from these livers is quite low and for some patients, it's probably below the risk of dying while waiting for a transplant.
The following kinds of livers aren't more likely to transmit an infection or cancer, but they carry a higher risk of not working well:
A split liver or a partial liver transplant. Livers from young donors may be split into two pieces that are transplanted into two recipients. Getting a piece of a liver rather than a whole one may increase the risk of bleeding, problems with the bile duct and problems with the liver not working well.
Livers from older donors. Livers that come from donors age 55 and over appear not to work as well in patients with hepatitis C as livers from younger donors. In patients without hepatitis C, however, they appear to work just as well.
Livers donated after cardiac death. Most organ donation occurs after brain death, meaning the donor has been declared brain dead but all organs, including the heart, continue to work. When a liver's taken after the heart has stopped beating — called donation after cardiac death — there seem to be increased risks. The liver may not work as well, and the recipient may need an emergency second transplant. There also appears to be a higher rate of bile duct problems, meaning the recipient may need to have more procedures or the liver may not work well. And the risk of transplant failure appears to be 5 to 7 percent higher."
Regards,
Hector
I think you may be mistaken about new interferon drugs. There are new interferon free oral meds currently being tested in clinical trials.
I've heard of people where the donor liver wasn't a match.
One man I know, tried to get a live liver transplant. Of the 5 friends who offered to be his donor, none were a match.
His neighbor's 18 year old was in a fatal motorcycle wreck and the mother donated her son's liver specifically to the man.
That was 11 years ago and he's doing great.
I've heard of people where the donor liver wasn't a match.
One man I know, tried to get a live liver transplant. Of the 5 friends who offered to be his donor, none were a match.
His neighbor's 18 year old was in a fatal motorcycle wreck and the mother donated her son's liver specifically to the man.
That was 11 years ago and he's doing great.
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